Healthcare Provider Details

I. General information

NPI: 1598522484
Provider Name (Legal Business Name): KING EXPANSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4564 SOMERSET BLVD SE
BELLEVUE WA
98006-2220
US

IV. Provider business mailing address

12819 SE 38TH ST # 11
BELLEVUE WA
98006-1326
US

V. Phone/Fax

Practice location:
  • Phone: 855-854-6684
  • Fax:
Mailing address:
  • Phone: 855-854-6684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DR. MELANIE K HECKER
Title or Position: OWNER
Credential: AU.D.
Phone: 855-854-6684